| NPI | 1528631231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0027130) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0101043) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2024-07-11 |